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NPI Code Detail

MEDICARE: ALBERTSONS LLC

MEDICARE: ALBERTSONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy12731CO
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10615243OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1194762617
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBERTSONS LLC
Provider Business Mailing Address
First Line : 5150 W 120TH AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80020-3332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5150 W 120TH AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80020-3332
Country : US
Telephone Number : 303-404-3639
Fax Number : 303-469-6882
Authorized Official
Title or Position : NEW STORE ENROLLMENTS
Name : LORENZO TORRES
Credential :
Telephone Number : 847-916-4463
Provider Enumeration Date : 06/01/2006
Last Update Date : 09/11/2025

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Directions to “ALBERTSONS LLC ” Practice Location

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